Medication strategies in first episode psychosis patients : A survey among psychiatrists
(2022) In Early Intervention in Psychiatry 16(2). p.139-146- Abstract
Aim: There is an ongoing debate regarding the optimal timing of discontinuation of antipsychotic drugs for patients with first episode psychosis. Although most guidelines recommend maintenance therapy for at least 1 or 2 years after reaching remission, study results indicate that early discontinuation may be beneficial for at least a subsample of patients. To date, little is known about which medication strategies are applied in patients recovering from a first psychotic episode. In this study, we examined the beliefs and practices of clinicians on medication discontinuation. Methods: We performed a survey among 50 experienced Dutch psychiatrists to assess how often specific treatment strategies have been applied in the past 12 months,... (More)
Aim: There is an ongoing debate regarding the optimal timing of discontinuation of antipsychotic drugs for patients with first episode psychosis. Although most guidelines recommend maintenance therapy for at least 1 or 2 years after reaching remission, study results indicate that early discontinuation may be beneficial for at least a subsample of patients. To date, little is known about which medication strategies are applied in patients recovering from a first psychotic episode. In this study, we examined the beliefs and practices of clinicians on medication discontinuation. Methods: We performed a survey among 50 experienced Dutch psychiatrists to assess how often specific treatment strategies have been applied in the past 12 months, as well as their knowledge and expectations with respect to medication discontinuation. Results: Psychiatrists estimated that, after remission, they continued medication at the same dose for at least 12 months in 51.2% of cases, continued in a reduced dose in 33.8% of cases and discontinued medication in 9.1% of cases after 4.4 months of remission on average. Although the medication is discontinued in only a relatively small proportion of patients, almost half of all clinicians (45.9%) used this strategy at least once in the past 12 months. Conclusions: There is substantial practice variation in antipsychotic medication strategies after remission from a first psychotic episode. Future research on long-term effects of early medication discontinuation can guide clinicians in making evidence-based decisions when treating first-episode patients.
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- author
- Kikkert, Martijn ; Veling, Wim ; de Haan, Lieuwe ; Begemann, Marieke ; de Koning, Mariken and Sommer, Iris
- contributor
- Geraets, Chris LU
- author collaboration
- publishing date
- 2022-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antipsychotic medication, discontinuation, maintenance treatment, schizophrenia
- in
- Early Intervention in Psychiatry
- volume
- 16
- issue
- 2
- pages
- 139 - 146
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85118545377
- pmid:33754470
- ISSN
- 1751-7885
- DOI
- 10.1111/eip.13138
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2021 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.
- id
- 095007d3-ffa6-4917-9f0f-872395fb3b84
- date added to LUP
- 2024-10-21 10:52:27
- date last changed
- 2024-10-22 09:35:16
@article{095007d3-ffa6-4917-9f0f-872395fb3b84,
abstract = {{<p>Aim: There is an ongoing debate regarding the optimal timing of discontinuation of antipsychotic drugs for patients with first episode psychosis. Although most guidelines recommend maintenance therapy for at least 1 or 2 years after reaching remission, study results indicate that early discontinuation may be beneficial for at least a subsample of patients. To date, little is known about which medication strategies are applied in patients recovering from a first psychotic episode. In this study, we examined the beliefs and practices of clinicians on medication discontinuation. Methods: We performed a survey among 50 experienced Dutch psychiatrists to assess how often specific treatment strategies have been applied in the past 12 months, as well as their knowledge and expectations with respect to medication discontinuation. Results: Psychiatrists estimated that, after remission, they continued medication at the same dose for at least 12 months in 51.2% of cases, continued in a reduced dose in 33.8% of cases and discontinued medication in 9.1% of cases after 4.4 months of remission on average. Although the medication is discontinued in only a relatively small proportion of patients, almost half of all clinicians (45.9%) used this strategy at least once in the past 12 months. Conclusions: There is substantial practice variation in antipsychotic medication strategies after remission from a first psychotic episode. Future research on long-term effects of early medication discontinuation can guide clinicians in making evidence-based decisions when treating first-episode patients.</p>}},
author = {{Kikkert, Martijn and Veling, Wim and de Haan, Lieuwe and Begemann, Marieke and de Koning, Mariken and Sommer, Iris}},
issn = {{1751-7885}},
keywords = {{antipsychotic medication; discontinuation; maintenance treatment; schizophrenia}},
language = {{eng}},
number = {{2}},
pages = {{139--146}},
publisher = {{Wiley-Blackwell}},
series = {{Early Intervention in Psychiatry}},
title = {{Medication strategies in first episode psychosis patients : A survey among psychiatrists}},
url = {{http://dx.doi.org/10.1111/eip.13138}},
doi = {{10.1111/eip.13138}},
volume = {{16}},
year = {{2022}},
}